| Aetna | Ultra Rapid Detoxification (UROD) | 2025-12-17 |
| Aetna | Breast Pumps | 2025-12-17 |
| Aetna | Tuberculosis Testing | 2025-12-17 |
| Aetna | Transpupillary Thermal Therapy | 2025-12-17 |
| Humana Medicaid | Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - OKLAHOMA | 2025-12-17 |
| Humana Medicaid | Molecular Diagnostic Assays and Breath Testing for Transplant Rejection - MEDICAID - FLORIDA | 2025-12-17 |
| Molina Clinical Policy | Itvisma (onasemnogene abeparvovec) MEDICARE | 2025-12-17 |
| Molina Clinical Policy | Steerable Ureteroscopic Renal Evacuation MEDICARE | 2025-12-17 |
| HealthPartners | Residential treatment and partial hospitalization | 2025-12-17 |
| Aetna | Positron Emission Tomography (PET) | 2025-12-16 |